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Introduction
Skills and Expertise
Publications
Publications (73)
Objectives
To identify the social inclusion needs that were (i) most commonly identified and (ii) most and least commonly prioritised as support planning goals for mental health service users living in supported accommodation, using the online Social Inclusion Questionnaire User Experience (SInQUE). We qualitatively examined mental health supported...
Objectives: To identify the social inclusion needs that were i) most commonly identified and ii) most and least commonly prioritised as support planning goals for mental health service users living in supported accommodation, using the online Social Inclusion Questionnaire User Experience (SInQUE). We qualitatively examined mental health supported...
BACKGROUND
Individuals with severe mental illness living in supported accommodation are often socially excluded. Enabling social inclusion is an important aspect of recovery-based practice, and improves quality of life. The Social Inclusion Questionnaire User Experience (SInQUE) is a measure of social inclusion that has been validated for use with...
Background
Individuals with severe mental illness living in supported accommodation are often socially excluded. Social inclusion is an important aspect of recovery-based practice and quality of life. The Social Inclusion Questionnaire User Experience (SInQUE) is a measure of social inclusion that has been validated for use with people with mental...
Background: Individuals with severe mental illness living in supported accommodation are often socially excluded. Enabling social inclusion is an important aspect of recovery-based practice, and improves quality of life. The Social Inclusion Questionnaire User Experience (SInQUE) is a measure of social inclusion that has been validated for use with...
People with mental health conditions are among the most socially excluded groups in society. Mental health conditions are influenced by the social environment, which in turn shapes our social and cultural responses to the people who experience them. Much of what mental health practitioners do is 'essentially social' and the effects of their interve...
People with mental health conditions are among the most socially excluded groups in society. Mental health conditions are influenced by the social environment, which in turn shapes our social and cultural responses to the people who experience them. Much of what mental health practitioners do is 'essentially social' and the effects of their interve...
This chapter examines the ways in which people with mental health conditions who also belong to other excluded groups may be particularly disadvantaged, in general and by mental health services. People with mental health conditions are at risk of social exclusion, but many from certain social identity groups are particularly at risk: for example, w...
This chapter pulls together the findings presented in Section 2 on the extent of social exclusion in people with mental health conditions and the possible causal links between social exclusion and mental ill-heath and health, to build a descriptive model linking these. The evidence supports the contention that people with mental health conditions a...
This chapter covers the development of social policies and the modern Welfare State. Welfare states represent recognition that the key welfare needs of the country will be met by the state through the provision of income transfers and key public services. Their development has been closely associated with the expansion of citizenship and human righ...
This chapter examines the changes in economic inequalities in the UK and internationally along with the links between poverty and inequality. We outline the way in which health and illness are distributed in the population and the psychosocial factors that operate to create and maintain health inequalities. Poverty and economic inequality are intri...
This chapter introduces Section 2 of the book and briefly examines the social inequalities that are risk factors for mental health conditions. Not only do we find that inequalities are associated with the prevalence of mental ill-health, the most disadvantaged also tend to have reduced access to mental health and social services, and, when they do...
This chapter outlines the levels of poverty, debt, and financial hardship in people with mental health conditions, the social security system, and living conditions, including neighbourhood deprivation, housing, and transport. People with mental health conditions are more likely to be excluded from material resources than others in society. They ar...
The term ‘social exclusion’ appears to have originated in France in the 1970s and had a significant influence on European social policy before being taken up by the UK’s New Labour Government in the 1990s. This chapter outlines the concepts of social exclusion and some of the competing discourses associated with the term. Several notable definition...
People with mental health conditions are among the most socially excluded groups in society. Mental health conditions are influenced by the social environment, which in turn shapes our social and cultural responses to the people who experience them. Much of what mental health practitioners do is 'essentially social' and the effects of their interve...
This chapter provides an overview of the methodological challenges in researching social inclusion amongst people with mental health conditions and gives examples of interventions that have been shown to be effective in addressing social exclusion including pre-school parenting programmes, early intervention, peer support, recovery colleges, self-c...
In this chapter we examine the historical background to poverty research, the definition and concepts of poverty, and how is it experienced by individuals, families, and communities. The focus is mainly on the UK and on qualitative studies. Poverty is a cause of human suffering and the experiences of people living in poverty are mediated by social...
This introductory chapter outlines the structure of the book and some of the themes that appear throughout the book. The themes include intersectionality, the role of social factors in causing and maintaining mental ill-health, the need for a public mental health approach, and the role of mental health professionals and services in facilitating soc...
This chapter examines the importance of family, social networks, social capital, and personal safety to people with mental health conditions and how these are often missing from their lives and replaced by social isolation and loneliness. For people with mental health conditions, social contacts and levels of support play a role in the genesis of t...
In this chapter we look at the social inequalities of physical health in relation to the poorer physical health experienced by people with mental health conditions and their access to health services. People with mental health conditions often experience a ‘triple jeopardy’: they experience an excess of physical health problems relative to their pe...
This chapter outlines concepts related to social exclusion that are relevant to people with mental health conditions. These concepts highlight the political and civil nature of exclusion (citizenship, equality and human rights, choice); the importance of material (poverty and deprivation), social (social capital, stigma, and discrimination) and ind...
In addition to adopting greater person-centred and recovery-oriented approach to build more productive partnerships between mental health staff and service users, mental health organisations that wish to become more socially inclusive need to develop partnerships with other agencies, particularly those that provide supported accommodation, supporte...
Groups who are socially excluded often lack a voice, something that holds for people with mental health conditions, especially if these are serious and enduring or if they are part of a socio-economically deprived group or a group that is marginalised because of their social identity. This chapter examines the involvement of people with mental heal...
Here we look at poverty from a quantitative viewpoint to examine trends over time as well as highlighting the social and demographic groups who are most disadvantaged. This reveals a section of society that faces the hardship of life on reduced resources and that lack the necessities for daily living. It also shows the central role that poverty pla...
The final section of the book examines how the social exclusion of people with mental health conditions can be tackled. Health services can play a part in improving health, but these services have traditionally been focussed on treatment and have a limited effect on the broader social determinants. The health of a nation is highly dependent on soci...
Here we examine governmental policies that affect how people with mental health conditions are treated in society. The development of UK mental health services has been closely associated with the evolution of social policies, the increasing role of the state in the provisions for the population’s well-being, and the ‘Welfare State’. The provision...
Background
Social inclusion is an important indicator of recovery in individuals with severe mental illness. The Social Inclusion Questionnaire User Experience (SInQUE) is a new measure of social inclusion for mental health service users which assesses five domains (consumption, production, access to services, social integration and civil engagemen...
Background
Individuals with severe mental health problems are at risk of social exclusion, which may complicate their recovery. Mental health and social care staff have, until now, had no valid or reliable way of assessing their clients’ social inclusion. The Social Inclusion Questionnaire User Experience (SInQUE) was developed to address this. It...
High levels of stigma and discrimination are reported by individuals with mental health problems. Aim: To assess self-reported levels of stigma and discrimination in forensic psychiatric patients, with psychotic illness, compared with general adult psychiatric patients with psychosis. Hypothesis: Individuals with a history of violent offending, as...
Background:
Looked-after children (LAC) are at greater risk of teenage pregnancy than non-LAC, which is associated with adverse health and social consequences. Existing interventions have failed to reduce rates of teenage pregnancy in LAC. Peer mentoring is proposed as a means of addressing many of the factors associated with the increased risk of...
Background
Absconds and escapes by psychiatric patients from secure forensic psychiatric settings create public anxiety and are poorly understood.AimsTo describe secure hospital patients who escape from within the secure perimeter or abscond, and test for differences between these groups.Method
Escapes and absconds between 2008 and 2012 from the me...
Randomised controlled trials (RCTs) are widely viewed as the gold standard for assessing effectiveness in health research; however many researchers and practitioners believe that RCTs are inappropriate and un-doable in social care settings, particularly in relation to looked after children. The aim of this article is to describe the challenges face...
Teenage pregnancy is associated with adverse health and social outcomes, even after adjusting for prior disadvantage, and is recognized as a major public health issue. Rates of teenage pregnancy in the UK are among the highest in Europe. Interventions introduced in the past decade to address the problem, such as improved sex and relationships educa...
Mental Health Act 1983 section136 allows a non-medically trained professional to deprive individual liberty on mere suspicion of a mental disorder, based on disorderly' behaviour in the community. This study describes the characteristics, presentation and outcomes of adolescents, subjected to s.136. Socio-demographic, psychiatric and s.136 data wer...
Background
People with mental health problems are known to be socially excluded but the contribution of pre-morbid characteristics, symptoms and needs, and the impact on quality of life is unknown.
Aims
To investigate change in social inclusion after the development of a psychotic Illness and factors associated with this.
Methods
A cross-sectiona...
Background
Social exclusion can be both a cause and a consequence of mental health problems. Socially inclusive practice by mental health professionals can mitigate against the stigmatizing and excluding effects of severe mental illness.
Aim
To develop and test the validity of a measure of social inclusion for individuals with severe mental illnes...
The ‘recovery approach’ to the management of severe mental health problems has become a guiding vision of service provision amongst many practitioners, researchers, and policy makers as well as service users.
This qualitative pilot study explored the meaning of ‘recovery’ with users of three specialist mental health services (eating disorders, dual...
The ‘Recovery Approach’ is widely regarded as the guiding principle for mental health service delivery in the UK. However, it is not clear whether this approach has any relevance, or is applicable to mentally disordered offender patients, who are almost invariably detained against their will and whose capacity to exert choice and control over their...
Amnesia for the perpetration of violent offences is an important issue in medico-legal proceedings. Previous studies of amnesia have mainly relied on selected groups of unconvicted offenders, which raises the question of how reliable the findings are. The purpose of this study was to examine the prevalence and phenomenological qualities of amnesia...
Very little is known about the nature of perpetrator's memories of violent crime. The authors conducted semistructured interviews with a representative sample of 105 young offenders convicted of serious violence, assessing intrusive memories, ruminations, and symptoms of posttraumatic stress disorder related to their violent crime. Forty-eight (46%...
The authors investigated factors that may determine whether perpetrators of violent crime develop intrusive memories of their offense. Of 105 young offenders who were convicted of killing or seriously harming others, 46% reported distressing intrusive memories, and 6% had posttraumatic stress disorder. Intrusions were associated with lower antisoci...
The development of single-sex medium secure units for women has been driven by concern about the vulnerability of women to sexual abuse and exploitation in mixed-sex secure settings. Less is known about how women patients and staff perceive gender segregation and their experiences in single-sex units.
To examine the impact of gender segregation on...
Background:
USA studies have reported high rates of co-morbid post-traumatic stress disorder (PTSD) and substance (drugs and alcohol) dependence/misuse. Avoidance of trauma reminders and associated distress may be achieved by the use of drugs and alcohol, alternatively a substance abusing lifestyle might predispose such individuals to experience t...
Although histories of abuse are associated with psychiatric illness in women, health professionals rarely enquire directly about such experiences. This study examined the association between physical and sexual violence and lifetime trauma and depressive and posttraumatic stress symptoms in women receiving maternity care.
Cross sectional study.
Sou...
To examine the prevalence of domestic violence (DV) and its associations with obstetric complications and psychological health in women on antenatal and postnatal wards.
A cross-sectional survey conducted in an inner-London teaching hospital. Two hundred English-speaking women aged 16 and over, were interviewed between July 2001 and April 2002. The...
There are no epidemiological data in Europe on associations between sexual molestation in males and psychological disturbance.
To investigate whether sexual molestation in males is a significant predictor of psychological disturbance.
We recruited men attending general practice and genitourinary medicine services. Participants took part in a comput...
Prevalence studies of sexual molestation in men attending genitourinary medicine (GUM) clinics have concentrated on experiences in adulthood or as a child, or on men who report male sexual partners only. Use of questionnaires in such studies can lead to under-reporting of 'sensitive' events. Our aim is to identify the lifetime prevalence of sexual...
A substantial minority of sexual offences against children are carried out by children. This article examines a case of pre-pubescent sexual offending associated with repeated reconstructive surgery to the penis, in the treatment of the congenital deformity hypospadias. Although the surgery involved was appropriate, the patient appeared to experien...
To identify the lifetime prevalence of non-consensual sexual experiences in men, the relationship between such experiences as a child and as an adult, associated psychological and behavioural problems, and help received.
Cross sectional survey.
England.
2474 men (mean age 46 years) attending one of 18 general practices.
Experiences of non-consensua...
Violent crime is on the increase in Britain, with 17% of the 15 million incidents of crime reported in 1991 being of a violent nature. Although there is some information on the role of accident and emergency departments for victims who sustain physical injury, little is known about the role of the general practitioner (GP) in managing the acute and...
A group of 13 child sex abusers over the age of 65 years is described. They are similar in most respects to sex offenders against children in other age groups, with regard to the seriousness of the abusive behaviours described, but they differ in terms of being of higher socioeconomic status, having stable backgrounds and reporting low rates of per...
Domestic violence is reported by up to one in four women in Britain1 and represents a serious public health issue. The psychological and social consequences of domestic violence include alcohol and drug dependence, suicide attempts, depression, and post-traumatic stress disorder.2 3 Pregnancy may increase the risk of violence,4 5 6 7 and the patter...
This study examines the legal issues surrounding a case in which a man, with a history of sexual and other serious offences, disclosed to a forensic psychiatrist that he and his wife were receiving in vitro fertilization (IVF). It explores the extent to which potential clients for IVF treatment have their suitability assessed. The requirements that...
A selection of papers on victims of crime or interpersonal violence including domestic violence, sexual assault, physical assault and stalking behaviours is reviewed.The importance of interagency liaison is discussed as well as the neurobiological basis for the memory deficits apparent in post-traumatic stress disorder.
Fifteen women who had sought refuge from domestic violence were studied with a view to listing information about the nature of the violence experienced, the coping strategies and the psychological and social consequences of such violence. Compared with non-abused women the subjects were found to have lower self-esteem, higher rates of depression, g...
This case highlights the relationship between normal and abnormal grief, normal and abnormal bereavement reactions and post traumatic stress disorder following trauma. Issues pertaining to the definition of a victim are also raised. The concept of victimization is broadened to include intrapsychic experiences of trauma and the act of homicide is di...
Although there has been some published literature addressing ethical issues in the chemical treatment of sex offenders (Bowden, 1991; Greenland, 1988) there has been relatively little discussion about the ethics of offering psychotherapeutic treatments of various kinds. This article addresses several ethical issues that arise in the context of the...
Sexual harassment in the workplace has a significant effect on women's employment and women's psychological health in employment. The costs are considerable both in terms of individual suffering and also in terms of the economic cost to the workplace. Although primarily affecting women, it is not simply a ‘women’s issue', and must be seen to concer...
This review focuses on various aspects of victimization: epidemiology, causes, effects and treatment approaches. Post-traumatic stress disorder is one possible outcome of victimization. However, the impact of trauma is variable and multifactorial. The following review emphasizes that additional factors, such as childhood experiences, past personali...
Synopsis
Twenty-two men, who had been forcibly sexually assaulted, participated in a study to determine the circumstances of the attacks and the effects on the victims. The immediate and long-term responses were very similar to those described in female victims of rape.
Twelve women, reporting rape to the police, were interviewed on three occasions over a 4-month period. Their psychological and behavioural experiences, during that time, were compared with those of 12 controls: women who were attending a Family Planning Clinic and without a history of such trauma, and small numbers of victims of non-sexual assault....
Adult male victims of sexual assault appear to have similar reactions to female victims, but are more stigmatized, may experience greater subsequent anger and guilt, and are even less likely to report the offence than females.
Increased recognition of these assaults is called for, both in law and by victim support agencies, in order to reduce the s...
Synopsis
Jockeys based in racing stables in the Newmarket and Epsom areas of England were screened using the 26-item Eating Attitudes Test. The mean score of the EAT was 14·9, significantly above that reported for males in other studies. The response rate was poor, but 10 jockeys agreed to a full psychiatric and eating interview. The majority of jo...
